1. CAMC Stroke Center September 12,2013

2.  Drill down: Variance in capturing individualized risk factors Med Reconciliation discrepancies Education not documented Staff feedback – request visual cue

3.  Nursing staff own Stroke/TIA Education  Admission Assessment- added trigger ‘Is this pt a possible stroke/TIA?’ If yes, EMR will prompt a workflow for Stroke/TIA Education

4.  Stroke Education order in EMR  To facilitate documentation of patient specific risk factors, added risk factor drop- down box  Med Reconciliation process streamlined

6.  Per nursing feedback, added Stroke/TIA Education order to Nursing Scheduled assessments  Once Stroke Education flowsheet is opened, cannot exit flowsheet without addressing risk factors.  Variances in practice reported to Nurse Managers for individualized follow-up  TCT Stroke Champions  Continue ongoing and monthly monitoring to achieve goal of 100% compliance

8.  Compliance rate increased from 82.37% 2012 to 91.11% Jan-Jun2013  June 2013 at 100% compliance  Benchmarks: TJC Nat’l Avg. 91.58% Premier top 25% 93%